According to researchers in the current study, "the introduction of highly active antiretroviral therapy has relaunched the debate on risky sexual behavior among HIV-infected gay men." They sought to examine the influences of lifestyle characteristics and health-related quality of life (HRQL) on unsafe sex with casual partners in a representative sample of HIV-positive gay men in France.

A 2003 national survey based on face-to-face interviews was conducted among a representative sample of patients selected in a random stratified sample of 102 French hospital departments providing HIV care. Gay men who reported having had casual sex partners during the previous 12 months were selected. Unsafe sex was defined as having at least one episode of unprotected anal sex with a casual partner during the previous 12 months. Researchers used the SF-36 Scale to determine HRQL. Patients who reported they had engaged in unsafe sex were compared to those who said they had not done so using chi-square test and logistic regressions.

Of the 1,117 study participants, 607 reported having had causal partners in the past year, of whom 20 percent (140) had engaged in unsafe sex. Poor mental HRQL was found in 68 percent of patients and was independently associated with unsafe sex, even after multiple adjustment for number of partners, binge drinking episodes, use of anxiolytics, use of Internet, and use of outdoor and commercial venues for sex.

"Risky sexual behavior with casual partners is frequent among HIV-infected gay men," the researchers concluded. "In addition to other well-known factors, behavior of this kind was found in this study to be related to poor mental HRQL. A more comprehensive approach to care designed to improve mental quality of life might therefore make for more effective secondary prevention."

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